New report warns millions could lose health care under GOP plan

As pressure mounts on the Trump administration and congressional GOP leaders to come up with a replacement for Obamacare that won't lead to huge losses in health care coverage for Americans, a new study presented at the National Governors Association over the weekend suggests that millions would be hurt under an emerging House GOP plan.

The analysis prepared by the health research firm Avalere Health and the consulting firm McKinsey and Company doesn't offer nationwide projections for declines in coverage if the House Republican plan were approved by Congress as a replacement for the Affordable Care Act. However, the analysis -- first reported Saturday by VOX -- indicates that there could be reductions of 30 percent to 50 percent in the number of individual market enrollees based on hypothetical state models. As it stands, the average retention rate of Obamacare insurance is 76-80 percent or a 16- 20 percent drop annually from signup to paying for premiums.

Still, if those projections are extrapolated nationwide, it suggests that many of the 7.7 million people who obtained health coverage through the exchanges would no longer be able to afford it.

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Preventative health care costs under Trump

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Preventative health care costs under Trump

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President Trump last month boasted that the GOP replacement plan would provide health care coverage for "everybody," but he and his senior advisers subsequently backed away from that. Republicans now say that their approach would provide "universal access" to affordable health care, but without guaranteeing that everyone currently enrolled can hang on to their insurance.

The White House on Sunday refused to say whether Trump would guarantee that the 7.7 million of Americans currently enrolled in Obamacare would continue to have coverage under a Republican substitute plan. During an appearance on the ABC News show This Week, Deputy White House press secretary Sarah Huckabee Sanders said, "the goal is that we make sure that people don't lose their coverage and we have to put a high priority on the people who need it most."

"But at the same time, we cannot survive under the current system," she added. "We have to make a massive overhaul to the health care system in America . . . Nobody would argue that we're on a path that we can maintain."

The House plan drafted by Speaker Paul Ryan (R-WI) and other GOP leaders may be formally introduced as early as Monday when Congress returns from a week-long recess. The past week has been marked by angry protests at town hall meetings and marches in Washington, D.C., and other cities involving Democrats and some Republicans who are fearful of losing their health insurance coverage.

If Trump and GOP leaders have their way, Congress will vote in the coming weeks to repeal key elements of the Affordable Care Act, including income-based tax subsidies for mostly low and moderate income people to help cover their premium costs and expanded Medicaid coverage in 31 states and the District of Columbia.

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Protests for and against Obamacare

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Protests for and against Obamacare

Tea Party Patriots supporters hold signs protesting the Affordable Care Act in front of the Supreme Court as the court hears arguments on the health care reform bill on Tuesday, March 27, 2012.

A man holds signs during a protest on the second day of oral arguments for the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court building on March 27, 2012 in Washington, DC. Today is the second of three days the high court has set aside to hear six hours of arguments over the constitutionality President Barack Obama's Patient Protection and Affordable Care Act.

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Sister Caroline attends a rally with other supporters of religious freedom to praise the Supreme Court's decision in the Hobby Lobby, contraception coverage requirement case on June 30, 2014 in Chicago, Illinois. Oklahoma-based Hobby Lobby, which operates a chain of arts-and-craft stores, challenged the provision and the high court ruled 5-4 that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom.

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An Obamacare supporter counter protests a Tea Party rally in front of the U.S. Supreme Court in the morning hours of March 27, 2012 in Washington, DC. The Supreme Court continued to hear oral arguments on the Patient Protection and Affordable Care Act.

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Affordable Care Act supporters hold up signs outside the Supreme Court as they wait for the court's decision on Obamacare on Thursday, June 25, 2015.

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Ron Kirby holds a sign while marching in protest of the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court on March 26, 2012 in Washington, DC. Today the high court, which has set aside six hours over three days, will hear arguments over the constitutionality President Barack Obama's Patient Protection and Affordable Care Act.

(Photo by Mark Wilson/Getty Images)

A protester waves his bible in the air as he overpowered by cheers from supporters of the Affordable Care Act as they celebrate the opinion for health care outside of the Supreme Court in Washington,Thursday June 25, 2015. The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama's health care overhaul, in a ruling that preserves health insurance for millions of Americans.

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Nuns, who are opposed to the Affordable Care Act's contraception mandate, and other supporters rally outside of the Supreme Court in Washington, D.C., U.S., on Wednesday, March 23, 2016. On Wednesday morning, the Supreme Court is scheduled to hear oral arguments in Zubik v. Burwell, a consolidated case brought by religious groups challenging a process for opting out of the Affordable Care Act's contraception mandate.

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Supporters of contraception rally before Zubik v. Burwell, an appeal brought by Christian groups demanding full exemption from the requirement to provide insurance covering contraception under the Affordable Care Act, is heard by the U.S. Supreme Court in Washington March 23, 2016.

(REUTERS/Joshua Roberts)

Protestors hold placards challenging 'Obamacare' outside of the US Supreme Court on March 4, 2015 in Washington, DC. The US Supreme Court heard a second challenge to US President Barack Obama's Affordable Care Act. The US Supreme Court faces a momentous case Wednesday on the sweeping health insurance reform law that President Barack Obama wants to leave as part of his legacy. The question before the court is whether the seven million people or more who subscribed via the government's website can obtain tax subsidies that make the coverage affordable. A ruling is expected in June.

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Linda Door (L) protests against President Obama's health care plan in front of the U.S. Supreme Court Building on March 26, 2012 in Washington, DC. Today the high court, which has set aside six hours over three days, will hear arguments over the constitutionality President Barack Obama's Patient Protection and Affordable Care Act.

(Photo by Mark Wilson/Getty Images)

Supporters of the Affordable Care Act celebrate after the Supreme Court up held the law in the 6-3 vote at the Supreme Court in Washington June 25, 2015. The U.S. Supreme Court on Thursday upheld the nationwide availability of tax subsidies that are crucial to the implementation of President Barack Obama's signature healthcare law, handing a major victory to the president.

(REUTERS/Joshua Roberts)

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In place of Obamacare, the House plan would offer a series of free-market based measures, including age-adjusted tax credits that would benefit older, wealthier people far more than younger, poorer Americans. The Republicans would also gradually replace Medicaid with a program of block grants or per capita payments to the states that would save the federal government billions in the coming years but reduce coverage for lower-income people.

The consultants' report to the governors outlines what would happen under the GOP approach in a hypothetical state that has 300,000 people enrolled in the individual health care market and expanded Medicaid for the poor. Enrollment in the individual market would decline by 30 percent, resulting in 90,000 people losing their coverage.

According to the report, the loss of coverage would be far worse in states that refused to expand their Medicaid programs under the ACA. Many of those states are run by Republican governors or GOP-dominated state legislatures. The report presents a hypothetical model of a state with 235,000 currently enrolled in the individual market. It estimates that coverage would decline by 120,000 people or about 50 percent.